A pilot study of leukocytapheresis efficacy with 1.5 liter blood processing volume in patients with ulcerative colitis.
Standard leukocytapheresis (LCAP) protocols recommend the processing of a 3 L blood volume. In this study, we evaluated the clinical effects of LCAP with 1.5 L of blood processing (1.5L-LCAP) in patients with active ulcerative colitis (UC). Ten patients with moderate to severe UC were enrolled. Their clinical and endoscopic responses, the kinetics of the peripheral blood counts and cytokine responses were evaluated. Clinical and endoscopic effects were assessed using the clinical activity index described by Rachmilewitz, and by Matts' endoscopic classification, respectively. The 1.5L-LCAP induced clinical remission in 8 out of 10 patients (80%). Endoscopic improvement was noted in 6 out of 7 patients (85.7%). Prednisolone (PSL) was used in 8 patients; the PSL dose could be reduced in 6 patients, and weaning was possible in one patient. Adverse effects were not observed during 1.5L-LCAP therapy. During the 1.5L-LCAP session, the leukocyte count reached the minimum at 1.0 L of blood processing, but promptly increased after completion of the session, and reached a maximum after 30 min. Interleukin (IL)-1beta-induced IL-8 and IL-6 secretion by peripheral blood mononuclear cells were both significantly reduced by 1.5L-LCAP therapy. 1.5L-LCAP was clinically effective for active UC patients. Cellular responses induced by 1.5L-LCAP were similar to those induced by a standard LCAP session.
Shimada
Masaaki
M
Department of Gastroenterology, National Hospital Organization, Nagoya Medical Center, Nagoya University Graduate School of Medicine, Nagoya, Japan. shimada@nnh.hosp.go.jp
Iwase
Hiroaki
H
Tsuzuki
Tomoyuki
T
Hirashima
Noboru
N
Kobayashi
Kyoko
K
Hibino
Yusuke
Y
Watanabe
Hisanori
H
Ryuge
Nobumitsu
N
Ando
Takafumi
T
Goto
Hidemi
H
Yagi
Yuhki
Y
Tsujikawa
Tomoyuki
T
Andoh
Akira
A
D000328:Adult; D001810:Blood Volume; D003093:Colitis, Ulcerative / Q000097:blood / Q000175:diagnosis* / Q000628:therapy*; D003113:Colonoscopy / Q000379:methods; D016207:Cytokines / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018836:Inflammation Mediators / Q000378:metabolism; D007937:Leukapheresis / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011336:Probability; D011446:Prospective Studies; D012074:Remission Induction / Q000379:methods; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
D016207:Cytokines; D018836:Inflammation Mediators